Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $39.06 / $39.06 / $39.06	Facility	26	$39.06	$39.06	$39.06
Aetna Facility/Professional Professional Modifier Low / Median / High Price $80.23 / $104.31 / $234.33	Professional		$80.23	$104.31	$234.33
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $15.71 / $39.06 / $76.20	Professional	26	$15.71	$39.06	$76.20
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $41.18 / $58.95 / $212.38	Professional	TC	$41.18	$58.95	$212.38
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $34.22 / $34.22 / $64.69	Professional	26	$34.22	$34.22	$64.69
BCBS Facility/Professional Professional Modifier Low / Median / High Price $87.35 / $485.00 / $750.53	Professional		$87.35	$485.00	$750.53
BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $33.29 / $42.79 / $58.52	Professional	26	$33.29	$42.79	$58.52
BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $44.56 / $60.94 / $562.51	Professional	TC	$44.56	$60.94	$562.51
Cigna Facility/Professional Professional Modifier Low / Median / High Price $88.61 / $163.05 / $601.00	Professional		$88.61	$163.05	$601.00
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $17.96 / $30.00 / $77.00	Professional	26	$17.96	$30.00	$77.00
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $57.66 / $120.61 / $576.00	Professional	TC	$57.66	$120.61	$576.00
Medcost Facility/Professional Facility Modifier 26 Low / Median / High Price $28.61 / $31.00 / $83.00	Facility	26	$28.61	$31.00	$83.00
Medcost Facility/Professional Professional Modifier Low / Median / High Price $351.77 / $351.77 / $351.77	Professional		$351.77	$351.77	$351.77
Medcost Facility/Professional Professional Modifier TC Low / Median / High Price $181.87 / $181.87 / $181.87	Professional	TC	$181.87	$181.87	$181.87
Molina Facility/Professional Professional Modifier Low / Median / High Price $44.14 / $80.55 / $129.73	Professional		$44.14	$80.55	$129.73
United Facility/Professional Professional Modifier Low / Median / High Price $98.74 / $142.62 / $457.33	Professional		$98.74	$142.62	$457.33
United Facility/Professional Professional Modifier 26 Low / Median / High Price $16.86 / $47.31 / $88.00	Professional	26	$16.86	$47.31	$88.00
United Facility/Professional Professional Modifier TC Low / Median / High Price $56.46 / $89.11 / $419.97	Professional	TC	$56.46	$89.11	$419.97